Bill Text: TX HB3923 | 2021-2022 | 87th Legislature | Comm Sub


Bill Title: Relating to multiple employer welfare arrangements.

Spectrum: Slight Partisan Bill (Republican 8-4)

Status: (Engrossed - Dead) 2021-05-26 - Placed on intent calendar [HB3923 Detail]

Download: Texas-2021-HB3923-Comm_Sub.html
 
 
  By: Oliverson, et al. (Senate Sponsor - Hancock) H.B. No. 3923
         (In the Senate - Received from the House May 5, 2021;
  May 10, 2021, read first time and referred to Committee on Business &
  Commerce; May 20, 2021, reported favorably by the following vote:  
  Yeas 9, Nays 0; May 20, 2021, sent to printer.)
Click here to see the committee vote
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to multiple employer welfare arrangements.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter A, Chapter 846, Insurance Code, is
  amended by adding Section 846.0035 to read as follows:
         Sec. 846.0035.  APPLICABILITY OF CERTAIN LAWS TO ASSOCIATION
  PROVIDING HEALTH BENEFITS. (a)  This section applies only to a
  multiple employer welfare arrangement:
               (1)  that was issued an initial certificate of
  authority under Section 846.054 on or after January 1, 2022; or
               (2)  that elects to be bound by this section in the
  manner prescribed by the commissioner.
         (b)  A multiple employer welfare arrangement that provides a
  comprehensive health benefit plan, as determined by the
  commissioner, is subject to the following laws as if the
  arrangement were an insurer, individuals entitled to coverage under
  the plan were insureds, and the health benefits were provided
  through an insurance policy:
               (1)  Chapter 421;
               (2)  Chapter 422;
               (3)  Subchapters C, F, and K, Chapter 1451; and
               (4)  Chapter 4201.
         (c)  A multiple employer welfare arrangement that provides a
  comprehensive health benefit plan, as determined by the
  commissioner, that is determined by the commissioner to be
  structured in the manner of a preferred provider benefit plan or an
  exclusive provider benefit plan as defined in Section 1301.001 is
  subject to the following laws as if the arrangement were an insurer,
  individuals entitled to coverage under the plan were insureds, and
  the health benefits were provided through an insurance policy:
               (1)  Chapter 1301; and
               (2)  Chapter 1467.
         SECTION 2.  Section 846.052(b), Insurance Code, is amended
  to read as follows:
         (b)  The application form must be completed and submitted
  along with all information required by the commissioner, including:
               (1)  a copy of each organizational document;
               (2)  current financial statements of the arrangement;
               (3)  a fully detailed statement indicating the plan
  under which the arrangement proposes to transact business;
               (4)  an initial actuarial opinion in compliance with
  the requirements of Section 846.153(a)(2) and subject to Section
  846.157(b); and
               (5)  demonstration [a statement] by the applicant
  [certifying] that the arrangement is in compliance with all
  applicable federal and state laws [provisions of the Employee
  Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et
  seq.)].
         SECTION 3.  Section 846.053, Insurance Code, is amended by
  amending Subsections (b) and (c) and adding Subsection (d-1) to
  read as follows:
         (b)  The employers in the multiple employer welfare
  arrangement must:
               (1)  be members of an association or group of five or
  more businesses that are in the same trade or industry, including
  closely related businesses that provide support, services, or
  supplies primarily to that trade or industry; or
               (2)  for a multiple employer welfare arrangement to
  which Section 846.0035 applies, each have a principal place of
  business in the same region that does not exceed the boundaries of
  this state or the boundaries of a metropolitan statistical area
  designated by the United States Office of Management and Budget.
         (c)  If the employers in the multiple employer welfare
  arrangement are members of an association, the association must:
               (1)  be engaged in substantial activity for its
  members other than sponsorship of an employee welfare benefit plan;
  and
               (2)  if Section 846.0035 does not apply to the multiple
  employer welfare arrangement, have been in existence for at least
  two years before engaging in any activities relating to providing
  employee health benefits to its members.
         (d-1)  For purposes of a multiple employer welfare
  arrangement to which Section 846.0035 applies, a working owner of a
  trade or business without employees may qualify as both an employer
  and as an employee of the trade or industry for the purposes of this
  section.  In this subsection, "working owner" means an individual
  who:
               (1)  has an ownership right of any nature in a trade or
  business, whether incorporated or unincorporated, including a
  partner and other self-employed individual;
               (2)  earns wages or self-employment income from the
  trade or business for providing personal services to the trade or
  business; and
               (3)  either:
                     (A)  works on average at least 20 hours per week or
  at least 80 hours per month providing personal services to the
  working owner's trade or business; or
                     (B)  has wages or self-employment income from the
  individual's trade or business that at least equals the
  individual's cost of coverage for participation by the individual
  and any covered beneficiaries in the group health plan sponsored by
  the group or association in which the individual is participating.
         SECTION 4.  This Act takes effect September 1, 2021.
 
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